Rebirth of a hospital

What happens if you are pregnant and in labor on Aug. 5, the day the new Orange Regional Medical Center opens? Or if you cut yourself and need stitches? Or if you need emergency surgery?

Which hospital should you report to?

These are just a few scenarios Orange Regional officials considered and planned for, in preparation for opening the new hospital and closing the Arden Hill and Horton campuses, all occurring within a 12-hour window.

Patients presenting to emergency departments at Horton and Arden Hill before 5 a.m. will be treated and discharged or transferred to the new hospital when they are stable.

But, once 5 a.m. rolls around, the new hospital will be fully operational, and patients presenting at the two campuses will be directed there for treatment, unless their care is deemed urgent.

Medical professionals will staff all three hospitals to treat emergencies and conduct emergency surgery if needed.

Patients are asked, if possible, to go to the new hospital, where staff will be prepared for women in labor and patients needing emergency surgery. They'll be able to treat victims of car accidents and other emergencies.

"We're expecting to get real emergencies that day," said Rob Lee, executive director of public relations and marketing.

Orange Regional officials spent the last three years piecing together the strategy they will be following Aug. 5 to ensure a safe and smooth transition to the new hospital.

They hired Parsons Corp., a move management group, which worked monthly with the nursing department and other department heads to devise the plan. Once complete, it was submitted to and approved by the state Department of Health. Officials conducted three drills in May and June — all of which went smoothly, they said — to prepare for the official move.

"This is not an overnight plan," Iberger said. "It's been planned for many years, over probably three years and certainly before that with the inception of the concept of building a new hospital."

In determining when to open the hospital, officials studied the inpatient daily census, which showed that Fridays are typically slower days. That's how Aug. 5 was chosen, and officials believe they will move between 280 and 300 patients that day.

Here's a snapshot of what to expect the days before and the day of the move.

-- The Horton and Arden Hill campuses won't schedule any elective surgeries after noon on Wednesday, Aug. 3.-- Hospital officials will notify patients Tuesday, Aug. 2, three days prior to the move, that they will move with the opening of the new hospital. More details will be released each day leading up to the move.-- Orange Regional has contracted with Mobile Life Ambulance Services to move patients from Horton and Arden Hill simultaneously to the new hospital. -- The move will begin at 5:30 a.m., with the most critically ill patients from both campuses transferred first to the new hospital. Obstetrics patients will follow, then patients in transitional critical care, and finally patients in the medical/surgical unit. Behavior health patients will be transported as well, entering through the separate Emergency Department elevator. Hospital officials expect to move 25 to 30 patients an hour.

There are contingency plans in place for seriously ill patients on life support, all of which are standard protocol, officials said.

-- Patients on ventilators will be prepared for transport by a respiratory therapist,-- If a patient is unstable, a clinician will accompany the emergency medical staff on the ambulance to oversee and manage patient care.

-- Once patients settle into their new rooms, visitors and loved ones will be escorted from the hospital lobby to their rooms.-- Transport will be at the hospital's expense.-- Officials will post updates on Twitter throughout the day.

The hospital has contracted with an outside vender, Holberts Catering in Montgomery, to provide 5,000 boxed breakfasts and lunches and a refrigerated truck to feed patients, hospital staff and volunteers helping out with the move.

Patients will be fed at the old campuses or new hospital depending upon when they will be moved. Dinner will be prepared in the new hospital's kitchen by Orange Regional staff.

The hospital hired Graebel Relocation Services to move all supplies and equipment to the new hospital.

While monitors and defibrillators purchased within the last year and other high-end equipment will make the trip, most of the equipment currently used at Arden Hill and Horton will remain there. Hospital officials purchased brand new, state-of-the-art equipment for the new hospital.

After the patient move is completed, officials will break down and move one cardiac catheterization lab and one interventional radiology lab to the new hospital, where they will be installed.

The remaining equipment will be offered to Orange Regional's sister sites, including Catskill Regional Medical Center. It will also be offered to the new owners or tenants at the two campuses. Whatever is left will be auctioned off.

Hospital officials worked with the state and county Office of Emergency Management, state police, state Department of Transportation, Orange County Sheriff's Office and Town of Wallkill Police in the weeks and months prior to the move to ensure a smooth and efficient relocation.

They worked out plans in case there is a major emergency on the day of the move, and incorporated scenarios, such as a major car crash on Route 17 with injuries, during drills held in May and June.

Mobile Life will be engaged in the move, but no other ambulance corps or organizations will be affected. Emergency medical personnel have all been notified of the move. At least three alternative routes have been mapped out and timed to get to the new hospital while bypassing traffic caused by the move.

On opening day, officials will activate the Hospital Incident Command System, with centers established at all three hospitals, to coordinate and manage the move. Orange County Emergency Management will operate its Incident Command Center to provide additional support if needed.

There will be one designated ambulance each at Arden Hill and Horton to direct or transport patients who show up there Aug. 6 or 7. Hospital officials will monitor the use and extend the time frame if needed.

There will also be signs at Arden Hill and Horton reminding people that those campuses are closed.

By Friday evening, Orange Regional Medical Center will be just one hospital, the first new hospital to be built in New York in more than two decades.

asunkin@th-record.com

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